CORA ABSTRACT #I - 1

DISTRACTION EXTERNAL FIXATOR FOR THE TREATMENT OF PERTHES DISEASE

S. Papp

D. Borschneck

L. Davidson

Prognostic signs in Perthes disease include age of child at onset of disease and the amount of collapse of femoral head. Containment treatment, usually a femoral or pelvic osteotomy, is recommended in children with a poor prognosis. A distracting external fixator will unload the femoral head during the disease process, in addition to obtaining coverage. At our center, we have treated eight -at risk-children with a distracting external fixator. An articulated fixator was applied with the hinge centered over the hip joint. Seven Boys and one girl with Herring classification B/C collapse, average age 8+4 were treated with this articulated EBI fixator. The fixator was on for an average of 102 days. Follow-up radiologic assessment shows six of eight patients with Stulberg Grade 3 outcome or better. In one child, containment was lost after removal of the fixator and the patient went on to need surgical containment. All patients showed significant proximal femoral osteopenia over the treatment period with slow resolution. At early follow-up, distraction and containment with the use of an EBI articulated fixator may offer a viable alternative treatment option for patients with Perthes disease.